The American Congress of Obstetricians and Gynecologists (ACOG), the American Cancer Society (ACS), the American Society for Colposcopy and Cervical Pathology (ASCCP), the American Society for Clinical Pathology (ASCP), the American College of Physicians (ACP) and the U.S. Preventive Services Task Force issue periodic updates on screening for certain diseases.

A recent debate has been over how often women need pelvic exams.

But one recommendation that Dr. Jacqueline S. Kates, along with Dr. Robert S. Wool, who specialize in obstetrics and gynecology at Women's Health Associates of Springfield and Westfield, believe should be clear is the importance of the "annual well woman visit," for routine gynecologic care.

Kates said changing recommendations on the frequency of Pap tests, which check for cervical cancer, has some women unsure whether they need to visit their gynecologist on a yearly basis.

“ACOG and a lot of the overriding organizations, including ASCCP, have within the past five to eight years, changed guidelines regarding Pap testing,” Kates said.

“We’re finding that a lot of women are equating the annual visit with a Pap test, and that’s not true. It seems like we’re doing a lot of counseling. Even though we’re not doing a Pap test each visit, it’s important that they come in for an annual visit.”

It is now recommended that women age 21 to 30, who are at low risk for health problems, receive a Pap test every three years. At 30, it is recommended that low-risk women receive a Pap test every three years, or a Pap with HPV (human papillomavirus) test every five years. Kates said she prefers the Pap with HPV screening, and ACOG also recommends it.

Beginning at age 65, women no longer need a Pap test if they do not have a history of moderate or severe dysplasia or cancer, and they have had either three negative Pap test results in a row, or two negative co-tests (Pap with HPV) in a row within the past 10 years, with the most recent test performed within the past five years.

Risk factors for women, which would result in doctors ordering more frequent Pap tests, include those who are immune compromised, those with a history of cervical cancer or dysplasia, and those who’ve had any sort of cervical abnormalities in pelvic exams. There are also special recommendations for DES-exposed daughters.

Kates said it’s still important, for many reasons, for women to visit their gynecologist annually for a pelvic exam, even without risk factors.

“A Pap test does not equate with an annual gynecological appointment,” Kates said. “There are multiple components to the appointment: a review of past medical history, we address any current issues or problems, we talk about physical activity, sexual health, tobacco and alcohol use.”

It gives doctors an opportunity to address overall health care of the patient, to educate them about risk factors and signs and symptoms of various diseases.

“Obviously, we want to identify medical problems, so the visit can be a tool to identify those problems,” she said. “It’s also important to establish or continue the patient/physician relationship.”

The pelvic exam is also important for early detection of cervical, ovarian and other cancers and checking for lesions, masses and infections.